股骨近端外侧壁的解剖学研究及其对转子间骨折内固定的意义

发布时间：2018-02-01 08:18

本文关键词： 股骨近端外侧壁外侧骨皮质转子外侧壁外侧壁软组织转子间骨折　出处：《中国临床解剖学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的研究观测股骨近端外侧壁的骨性与软组织解剖特征,为临床向股骨头内打入拉力螺钉或螺旋刀片的股骨外侧皮质提供参考数据。方法采用16例成人股骨干燥标本、10例尸体下肢标本和20例老年股骨转子间骨折的横断面CT图像,分别测量外侧壁的骨性面积、软组织附着及其面积以及外侧壁骨皮质的厚度。结果骨性外侧壁平均高(24.4±2.4)mm,宽(23.3±2.0)mm,面积(567.0±82.8)mm2。臀中肌、臀小肌的止点与股外侧肌起点,在外侧壁处相互交织,形成致密坚韧的腱膜样重叠部,平均高(33.2±2.3)mm,宽(28.2±1.9)mm,厚(1.6±0.1)mm。老年人小转子平面的股骨外侧壁皮质薄弱,厚仅(2.3±0.5)mm。结论老年股骨转子间骨折的外侧壁皮质薄弱,容易骨折。推荐选用头髓钉系统进行内固定治疗,具有较高的安全性。
[Abstract]:Objective to study the bone and soft tissue anatomy of proximal lateral wall of femur. Methods 16 adult femur dry specimens were used to provide reference data for clinical application of femoral lateral cortex with lashing screws or helical inserts into the femoral head. Cross-sectional CT images of 10 cadaveric lower limb specimens and 20 elderly femoral intertrochanteric fractures were used to measure the bone area of lateral wall. Results the average height of lateral wall of bone was 24.4 卤2.4 mm and the width of lateral wall was 23.3 卤2.0 mm. The area was 567.0 卤82.8mm2. The insertion point of the gluteus minor muscle and the origin of the lateral femoral muscle intertwined with each other to form a dense and tough aponeurosis like overlap. The average height was 33.2 卤2.3 mm, the width was 28.2 卤1.9 mm, and the thickness was 1.6 卤0.1 mm. The lateral wall of femur was weak in the small trochanter plane of the elderly. Conclusion the lateral cortex of the femoral intertrochanteric fracture is weak and easy to fracture. It is recommended to use the head nail system for internal fixation, which has high safety.
【作者单位】：同济大学附属杨浦医院骨科;
【基金】：上海市科委医学引导类基金资助(14411971900)
【分类号】：R687.3
【正文快照】： 股骨近端外侧壁(proximal femoral lateral wall),亦称转子外侧壁(trochanteric lateral wall)或股骨近端外侧皮质(proximal femoral lateral cortex),是以色列骨科医生Gotfried[1]在2004年,针对滑动加压髋螺钉(如135°DHS)治疗股骨转子间骨折发生失败而提出的外科概念,在解剖

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